The Baby-friendly Hospital Initiative (BFHI) is a global programme to apply the Ten Steps to Successful Breastfeeding as the standard of care in all maternity and newborn services. This monitoring manual provides countries with various tools and strategies for monitoring adherence to the Ten Steps. It is intended to guide governments and key stakeholders in planning BFHI monitoring activities, including data collection and analysis. The primary audience includes quality improvement and assurance teams, regional or administrative entities, public health officials, and programme managers. The manual describes opportunities for monitoring at three levels: within maternity and newborn health care facilities themselves, external quality assurance processes, and at the national level for programme planning and evaluation.